“Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England
IntroductionThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service has shown promising outcomes for young people with an eating disorder, leading to national scaling and implementation across England. Between 2020 and 2023, the national implementation of FREED was supported...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Health Services |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frhs.2023.1253966/full |
| _version_ | 1797351405445447680 |
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| author | Lucy Hyam Claire Torkelson Katie Richards Amy Semple Karina L. Allen Karina L. Allen Jill Owens Aileen Jackson Laura Semple Danielle Glennon Giulia Di Clemente Ulrike Schmidt Ulrike Schmidt |
| author_facet | Lucy Hyam Claire Torkelson Katie Richards Amy Semple Karina L. Allen Karina L. Allen Jill Owens Aileen Jackson Laura Semple Danielle Glennon Giulia Di Clemente Ulrike Schmidt Ulrike Schmidt |
| author_sort | Lucy Hyam |
| collection | DOAJ |
| description | IntroductionThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service has shown promising outcomes for young people with an eating disorder, leading to national scaling and implementation across England. Between 2020 and 2023, the national implementation of FREED was supported by the Academic Health Science Networks (AHSNs), which are publicly funded organisations with the mission to spread innovations at scale and pace. This study aimed to investigate the views and experiences of AHSN programme leads on the national roll-out of FREED and the perceived sustainability of the model.Methods and resultsSemi-structured interviews were conducted with 13 programme leads across the AHSNs with direct experience supporting the national implementation of FREED. Thematic analysis was adopted using a critical realist approach. Initial sub-themes were inductively generated and then organised under seven larger themes representing the domains of the Non-adoption, Abandonment, and Challenges to Scale-Up, Spread and Sustainability (NASSS) framework. Each sub-theme was classified as a facilitator and/or barrier and then each larger theme/domain was assessed for its complexity (simple, complicated, complex). Data analysis revealed 28 sub-themes, 10 identified as facilitators, 13 as barriers, and five as both. Two domains were classed as simple, three as complicated, and two as complex. Sub-themes ranged from illness-related complexities to organisational pressures. Key facilitators included a high-value proposition for FREED and a supportive network. Key barriers included staffing issues and illness-related factors that challenge early intervention.DiscussionParticipants described broad support for FREED but desired sustained investment for continued provision and improving implementation fidelity. Future development areas raised by participants included enlarging the evidence base for early intervention, increasing associated training opportunities, and widening the reach of FREED. Results offer learning for early intervention in eating disorders and the scaling of new health initiatives. |
| first_indexed | 2024-03-08T12:59:58Z |
| format | Article |
| id | doaj.art-113d89c14b814127b3af4cb066929d6b |
| institution | Directory Open Access Journal |
| issn | 2813-0146 |
| language | English |
| last_indexed | 2024-03-08T12:59:58Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Health Services |
| spelling | doaj.art-113d89c14b814127b3af4cb066929d6b2024-01-19T08:31:40ZengFrontiers Media S.A.Frontiers in Health Services2813-01462024-01-01310.3389/frhs.2023.12539661253966“Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in EnglandLucy Hyam0Claire Torkelson1Katie Richards2Amy Semple3Karina L. Allen4Karina L. Allen5Jill Owens6Aileen Jackson7Laura Semple8Danielle Glennon9Giulia Di Clemente10Ulrike Schmidt11Ulrike Schmidt12Centre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomDepartment of Psychosis Studies, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomCentre for Implementation Science, King’s College London, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomHealth Innovation Network, Academic Health Science Network South London, London, United KingdomCentre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSouth London and Maudsley NHS Foundation Trust, London, United KingdomHealth Innovation Network, Academic Health Science Network South London, London, United KingdomHealth Innovation Network, Academic Health Science Network South London, London, United KingdomEating Disorders Outpatients Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, United KingdomSouth London and Maudsley NHS Foundation Trust, London, United KingdomSouth London and Maudsley NHS Foundation Trust, London, United KingdomCentre for Research in Eating and Weight Disorders, Department of Psychological Medicine, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United KingdomSouth London and Maudsley NHS Foundation Trust, London, United KingdomIntroductionThe First Episode Rapid Early Intervention for Eating Disorders (FREED) service has shown promising outcomes for young people with an eating disorder, leading to national scaling and implementation across England. Between 2020 and 2023, the national implementation of FREED was supported by the Academic Health Science Networks (AHSNs), which are publicly funded organisations with the mission to spread innovations at scale and pace. This study aimed to investigate the views and experiences of AHSN programme leads on the national roll-out of FREED and the perceived sustainability of the model.Methods and resultsSemi-structured interviews were conducted with 13 programme leads across the AHSNs with direct experience supporting the national implementation of FREED. Thematic analysis was adopted using a critical realist approach. Initial sub-themes were inductively generated and then organised under seven larger themes representing the domains of the Non-adoption, Abandonment, and Challenges to Scale-Up, Spread and Sustainability (NASSS) framework. Each sub-theme was classified as a facilitator and/or barrier and then each larger theme/domain was assessed for its complexity (simple, complicated, complex). Data analysis revealed 28 sub-themes, 10 identified as facilitators, 13 as barriers, and five as both. Two domains were classed as simple, three as complicated, and two as complex. Sub-themes ranged from illness-related complexities to organisational pressures. Key facilitators included a high-value proposition for FREED and a supportive network. Key barriers included staffing issues and illness-related factors that challenge early intervention.DiscussionParticipants described broad support for FREED but desired sustained investment for continued provision and improving implementation fidelity. Future development areas raised by participants included enlarging the evidence base for early intervention, increasing associated training opportunities, and widening the reach of FREED. Results offer learning for early intervention in eating disorders and the scaling of new health initiatives.https://www.frontiersin.org/articles/10.3389/frhs.2023.1253966/fullfeeding and eating disordersNational Health Servicesearly medical interventionmental health servicesemerging adulthoodimplementation research |
| spellingShingle | Lucy Hyam Claire Torkelson Katie Richards Amy Semple Karina L. Allen Karina L. Allen Jill Owens Aileen Jackson Laura Semple Danielle Glennon Giulia Di Clemente Ulrike Schmidt Ulrike Schmidt “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England Frontiers in Health Services feeding and eating disorders National Health Services early medical intervention mental health services emerging adulthood implementation research |
| title | “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England |
| title_full | “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England |
| title_fullStr | “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England |
| title_full_unstemmed | “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England |
| title_short | “Early intervention isn't an option, it's a necessity”: learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in England |
| title_sort | early intervention isn t an option it s a necessity learning from implementation facilitators and challenges from the rapid scaling of an early intervention eating disorders programme in england |
| topic | feeding and eating disorders National Health Services early medical intervention mental health services emerging adulthood implementation research |
| url | https://www.frontiersin.org/articles/10.3389/frhs.2023.1253966/full |
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